Depression common, but often unrecognized, in Parkinson’s

Feeling blue? It may be more than just the Portland winter weather getting you down if you have Parkinson’s disease.

About one-third of people with Parkinson’s disease suffer from clinical depression at any point in time and two-thirds will experience a depressive episode at some point during the course of the disease. The symptoms of depression include feeling worried, sad, tearful, tired, guilty, irritable, or unloved. People can lose interest in activities, have changes in sleeping and eating patterns and feel life is not worth living.

Depression is probably more common in persons with Parkinson’s due to a combination of factors. Dealing with a chronic disease can cause some depression and the neurochemical changes that occur from the disease appear to also have mood effects.

If you are feeling down and blue, be sure to talk to your doctor. If depressive symptoms are severe and you have thoughts of wanting to hurt yourself, you should call 911 or get to an emergency room for evaluation. Depression is one of the biggest factors in how people with Parkinson’s rate their quality of life. But the condition is often under recognized.

The good news is that there are therapies that can help treat depression.

Behavioral therapy with a counselor or a psychologist may be helpful. There also are two primary classes of medications specifically for depression that are used in Parkinson’s. One class is the selective serotonin reuptake inhibitors (or SSRIs) which include medications like citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).

The other class is the tricyclic antidepressants, which include amitriptyline and nortriptyline. Treating the Parkinson’s symptoms with medications that work on dopamine may also help to improve depression.

Finally, exercise, which also is helpful for the motor symptoms of Parkinson’s, may also improve mood. So get on your warm coat and rain boots and get out for a walk or head to the gym for an indoor workout. And above all, let your doctor know if you are experiencing symptoms of depression.

Amie Peterson, M.D.
Assistant Professor of Neurology
OHSU Parkinson Center of Oregon
OHSU Brain Institute